Search for articles
Intramyometrial Oxytocin in Preventing Postpartum Hemorrhage during Cesarean Delivery: A Systematic Review
Joanna Marie O. Guerra-Calilung, MD; Florante P. Gonzaga, MD, FACOG, FPOGS, FACS
Department of Obstetrics and Gynecology, The Medical City
Objective: The study aims to evaluate the efficacy and safety of intramyometrial oxytocin in preventing postpartum hemorrhage during cesarean deliveries.
Methods: A review was done involving electronic search of databases for randomized clinical trials published since 1980, and a check of all the references according to inclusion and exclusion criteria. Four full articles were retrieved and assessed for methodological quality. Data were extracted and analyzed.
Results: Comparisons involved (1) intramyometrial versus intravenous oxytocin, and (2) intramyometrial oxytocin against intramyometrial carboprost. Limited evidence showed significant reduction of postpartum hemorrhage (RR 0.40; 95% CI 0.19 to 0.82) and maternal adverse drug events (RR 0.10; 95% CI 0.01 to 0.75) with intramyometrial oxytocin compared to intravenous oxytocin. Maternal adverse events were reduced, but not significantly, in intramyometrial oxytocin compared with intramyometrial carboprost.
Conclusion: Guideline changes could not be recommended because there is insufficient information about intramyometrial oxytocin administration from the small number of studies and participants available.